Until now, the only reliable detector of a traumatic brain injury (TBI) is a computed tomography (CT) scan, which is only available in some hospitals and, in addition to being expensive, exposes patients to radiation.
Researchers from the University of Geneva (UNIGE) in Switzerland, in partnership with the Hospitals of Barcelona, Madrid and Seville, have developed a small device, called the Point-of-Care Test (POCT), that analyzes protein levels in the blood and can diagnose with a single drop of blood the possibility of a mild traumatic brain injury.
“We wondered if it was possible to isolate certain proteins whose presence in the blood increases in the event of mild traumatic brain injury,” says Jean-Charles Sanchez, professor at the Department of Internal Medicine of Specialties and the Biomarkers Centre of the Faculty of Medicine of the UNIGE.
“Our idea was to find a way to do a quick examination that would allow, during a boxing or American football match for example, to determine whether the athlete can return to the field or if his condition requires hospitalization. The opposite of the CT Scan, an exam that lasts a long time and cannot be done anywhere.”
During a shock to the head, some brain cells are damaged and release the proteins they contain, increasing their level in the blood.
For the study, researchers compared the blood of patients admitted for mild traumatic brain injury but diagnosed as negative with that of patients actually suffering from a brain lesion. Using proteomic analyses — which can quantify thousands of proteins simultaneously and observe variations in blood levels — the scientists gradually isolated four molecules indicating the presence of a brain injury: H-FABP, Interleukin-10, S100B and GFAP.
“We have noticed that the H-FABP level alone makes it possible to confirm that there is no risk of trauma in one third of patients admitted after a shock,” says Sanchez. The rest of the patients will have to undergo a CT scan to confirm the diagnosis.
It was necessary that the researchers develop a device that could be used everywhere, quickly and simply, and widely available in places such as pharmacies or sports halls.
The team then developed a rapid diagnostic test (POCT) called TBIcheck, inspired by the principle of pregnancy testing: by placing a single drop of blood on the well of a small 5cm plastic case, the patient knows within 10 minutes whether there is a risk of mild trauma, namely whether or not his H-FABP level is higher than 2.5 nanograms per millilitre of blood.
“If a lane appears, the injured person must go to a hospital for a CT scan, if there is nothing, he can go home safely!” Jean-Charles Sanchez says.
In case of doubt when reading the result, a small reader, the Cube Reader, can be installed on TBIcheck. It will display the word “positive” or “negative” and send the result to the patient’s or caregiver’s smartphone via Bluetooth.
The new findings are published in the journal PLOS ONE.
Source: University of Geneva